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A rare instance of latent systematic error in volumetric-modulated arc therapy with field-extended multi-isocentre irradiation leading to a serious dose-delivery accident. 容积调制弧线疗法中的一个罕见的潜在系统误差，该疗法采用场延伸多中心照射，导致了严重的剂量投放事故。
IF 0.5
BJR Case Reports Pub Date : 2024-07-17 eCollection Date: 2024-07-01 DOI: 10.1093/bjrcr/uaae021
Takashi Hanada, Junichi Fukada, Yutaka Shiraishi, Kayo Yoshida, Naoya Sakanoue, Kohei Oguma, Toshio Ohashi, Naoyuki Shigematsu
{"title":"A rare instance of latent systematic error in volumetric-modulated arc therapy with field-extended multi-isocentre irradiation leading to a serious dose-delivery accident.","authors":"Takashi Hanada, Junichi Fukada, Yutaka Shiraishi, Kayo Yoshida, Naoya Sakanoue, Kohei Oguma, Toshio Ohashi, Naoyuki Shigematsu","doi":"10.1093/bjrcr/uaae021","DOIUrl":"10.1093/bjrcr/uaae021","url":null,"abstract":"<p><p>Volumetric-modulated arc therapy (VMAT) with field-extended multi-isocentre irradiation (VMAT-FEMII) is an effective irradiation technique, particularly for large planning target volumes in the craniocaudal direction. A variety of treatment planning techniques have been reported to reduce the dosimetric impact. However, there is no guarantee that unexpected latent systematic errors would not occur. Herein, we report the experience with a rare case that could have led to a serious VMAT-FEMII-related accident. A patient with uterine cervical carcinoma was scheduled for VMAT-FEMII to the whole pelvis and the para-aortic lymph node region. A combination of the two sets of field groups with different isocentres was planned: one to cover the para-aortic lymph nodes and the other to cover the whole pelvis. Measurements based on the pretreatment dose delivery quality assurance (QA) revealed an unexpected overdose of >20% in the field overlap region. This overdose phenomenon is not reflected in the calculated dose distribution in the radiotherapy treatment planning system. Therefore, the plan was altered; a homogeneous dose distribution inside the dose junction was achieved. Several analyses were performed to elucidate the overdosing phenomenon. However, no conclusive answer was found to why non-reflection at the calculated dose distribution was found. The limitations to VMAT-FEMII are primarily related to systematic errors in the positional setup from patient-derived and/or mechanical sources. However, this report highlights a rare case of overdosing caused by inverse optimization and dose calculation. We recommend checking the aperture status of the jaw and multi-leaf collimator at each control point of the treatment plan and using a high-resolution image measurement system on a VMAT-FEMII QA to confirm the dose junction status.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11257714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A case of IgG4-related disease manifesting as a spinal epidural mass. 一例表现为脊柱硬膜外肿块的 IgG4 相关疾病。
IF 0.5
BJR Case Reports Pub Date : 2024-07-04 eCollection Date: 2024-07-01 DOI: 10.1093/bjrcr/uaae022
Hatty Hoi Ting Chau, Bill Archie Lo, Wai Pong Chu, Ho Nam Ho, Wilson Man-Shan Tsui
{"title":"A case of IgG4-related disease manifesting as a spinal epidural mass.","authors":"Hatty Hoi Ting Chau, Bill Archie Lo, Wai Pong Chu, Ho Nam Ho, Wilson Man-Shan Tsui","doi":"10.1093/bjrcr/uaae022","DOIUrl":"10.1093/bjrcr/uaae022","url":null,"abstract":"<p><p>IgG4-related disease is an immune-mediated fibroinflammatory condition. Isolated manifestation in the spine as hypertrophic pachymeningitis is very rare and the mass-like lesion on MRI often mimic tumour or infection. Patients would present with symptoms that result from mass effect or neurovascular compression. Studies showed that serum and CSF IgG4 levels are rarely informative, and therefore, tissue biopsy is crucial for accurate diagnosis. Apart from supporting the diagnosis, MRI is helpful in delineating the extent of disease and follow-up after treatment. A 18F-FDG PET/CT scan is useful in detecting systemic manifestations of IgG4-related disease. Although IgG4-related disease generally responds well to corticosteroid at inflammatory state, relapse is not uncommon. Current treatment strategies for IgG4-related hypertrophic pachymeningitis are high dose corticosteroid therapy and early decompressive surgery to avoid chronic neurological complications. We described a case of a 27-year-old gentleman complaining of lower limb weakness and numbness. MRI showed a mass-like epidural lesion at the thoracic spine causing cord compression. Open biopsy of the epidural mass demonstrated histopathological characteristics of IgG4-related disease. Patient responded well to early surgical decompression of the spinal cord and corticosteroid as evidenced by symptom improvement and resolving mass on subsequent MRI study. However, a follow-up MRI revealed disease recurrence years later.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11233069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Feasibility and flexibility of a novel multi-dose level avoidance reirradiation technical methodology in recurrent head and neck cancer. 新型多剂量水平避免再照射技术方法在复发性头颈癌中的可行性和灵活性。
IF 0.5
BJR Case Reports Pub Date : 2024-07-03 eCollection Date: 2024-07-01 DOI: 10.1093/bjrcr/uaae020
Thomas Hague, Rikki Lad, Kevin Chiu
{"title":"Feasibility and flexibility of a novel multi-dose level avoidance reirradiation technical methodology in recurrent head and neck cancer.","authors":"Thomas Hague, Rikki Lad, Kevin Chiu","doi":"10.1093/bjrcr/uaae020","DOIUrl":"10.1093/bjrcr/uaae020","url":null,"abstract":"<p><p>Reirradiation in recurrent head and neck cancer presents a considerable clinical challenge in radiation oncology. Though technically feasible due to advanced treatment delivery and planning techniques, confidence in delivering such treatments is not universal and patient selection is critical. Radiotherapy planning in reirradiation cases presents a complex technical challenge owing to the often-considerable overlap of dose from a patient's first treatment plan. This technical note describes three clinical case studies of recurrent head and neck cancer and the technical details of how their multidose level reirradiation was planned. Each patient had confirmed recurrence of squamous cell carcinoma and was referred for reirradiation to a previously irradiated area. The clinical details for each patient are provided before a detailed description of the treatment planning methodology is presented, which specifies how to approach such complex overlapping treatment volumes. The patient outcomes are described and a discussion is presented outlining the clinical challenges associated with these cases and the variables that must be accounted for when considering patients for potential reirradiation.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11233120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pseudotumour: an uncommon complication of severe haemophilia. 假性肿瘤：严重血友病的一种不常见并发症。
IF 0.5
BJR Case Reports Pub Date : 2024-06-20 eCollection Date: 2024-07-01 DOI: 10.1093/bjrcr/uaae019
Alex Kiu, Isaac Yang, Tiffany Fung, Rehana Jaffer, Marie-Helen Martin
{"title":"Pseudotumour: an uncommon complication of severe haemophilia.","authors":"Alex Kiu, Isaac Yang, Tiffany Fung, Rehana Jaffer, Marie-Helen Martin","doi":"10.1093/bjrcr/uaae019","DOIUrl":"10.1093/bjrcr/uaae019","url":null,"abstract":"<p><p>Pseudotumours are uncommon complications of haemophilia, occurring in 1%-2% of patients with haemophilia.<sup>1</sup> <sup>,</sup> <sup>2</sup> It is a slowly expanding haematoma as a result of recurrent haemorrhage, surrounded by a fibrous capsule. It can occur in both bone and soft tissue, and progressive enlargement may result in bone destruction and/or muscle and skin necrosis. Pseudotumours by themselves are usually painless though its mass effect can result in nerve compression resulting in pain or neurologic symptoms. It may also predispose to pathologic fractures (as in our case) and superimposed infections.<sup>2</sup> <sup>,</sup> <sup>3</sup>.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Perihepatic caudate lobe haematoma originating from a pancreatic pseudoaneurysm: a diagnostic dilemma. 源于胰腺假性动脉瘤的肝尾叶周围血肿：诊断难题。
IF 0.6
BJR Case Reports Pub Date : 2024-06-07 eCollection Date: 2024-05-01 DOI: 10.1093/bjrcr/uaae018
Ippei Ozaki, Yohsuke Suyama, Kohei Hamamoto, Eiko Hyoe, Mai Fujisaku, Hiroshi Shinmoto
{"title":"Perihepatic caudate lobe haematoma originating from a pancreatic pseudoaneurysm: a diagnostic dilemma.","authors":"Ippei Ozaki, Yohsuke Suyama, Kohei Hamamoto, Eiko Hyoe, Mai Fujisaku, Hiroshi Shinmoto","doi":"10.1093/bjrcr/uaae018","DOIUrl":"10.1093/bjrcr/uaae018","url":null,"abstract":"<p><p>Despite advances in diagnostic imaging and interventional techniques, pancreatic pseudoaneurysms remain a life-threatening complication of pancreatitis. Presentation varies among patients and may include intra-abdominal, retroperitoneal, or gastrointestinal bleeding and bleeding into the pancreatic or common bile duct. We present a unique case of a 74-year-old man with a history of heavy alcohol consumption who presented with a haematoma surrounding the caudate lobe of the liver. Initially, alcoholic cirrhosis and a ruptured hepatocellular carcinoma were suspected. Therefore, transarterial embolization (TAE) of the caudate branch of the hepatic artery was performed. However, 3 months later, the patient experienced abdominal pain with a lesser sac haematoma and a seemingly interconnected pancreatic cyst. One month later, a pseudoaneurysm appeared in the pancreatic cyst. TAE was successfully performed for the pseudoaneurysm, and the patient showed no signs of recurrence during the 1-year follow-up.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11165270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prostate specific membrane antigen PET avidity in a granular cell tumour of the left supraspinatus muscle: a case report. 左冈上肌颗粒细胞瘤中的前列腺特异性膜抗原 PET 阳性率：病例报告。
IF 0.6
BJR Case Reports Pub Date : 2024-05-29 eCollection Date: 2024-05-01 DOI: 10.1093/bjrcr/uaae015
Michael T Hsieh, Farokh Fargah, Abdul Rahim Mohd Tahir, Ngo Tue Le, Thomas P Shakespeare
{"title":"Prostate specific membrane antigen PET avidity in a granular cell tumour of the left supraspinatus muscle: a case report.","authors":"Michael T Hsieh, Farokh Fargah, Abdul Rahim Mohd Tahir, Ngo Tue Le, Thomas P Shakespeare","doi":"10.1093/bjrcr/uaae015","DOIUrl":"10.1093/bjrcr/uaae015","url":null,"abstract":"<p><p>Granular cell tumour is a rare, mostly benign, soft tissue, neuroectodermal tumour, most commonly seen in the skin and peripheral soft tissue. There are no publications to date of PSMA-PET avidity in a granular cell tumour. In this 60 year old male, staging PSMA-PET for a localized intermediate risk prostate cancer incidentally identified a PSMA-avid left supraspinatus lesion, which was subsequently biopsy-proven as a granular cell tumour. We present the first case of PSMA-avid granular cell tumour and add to the growing literature documenting PSMA-PET avidity in benign and malignant lesions apart from prostate cancer.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11153832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Chronic Q fever infective endocarditis: a case report. 慢性 Q 热感染性心内膜炎：病例报告。
IF 0.6
BJR Case Reports Pub Date : 2024-05-28 eCollection Date: 2024-05-01 DOI: 10.1093/bjrcr/uaae017
Badriya Al Suqri, Azza Al Brashdi
{"title":"Chronic Q fever infective endocarditis: a case report.","authors":"Badriya Al Suqri, Azza Al Brashdi","doi":"10.1093/bjrcr/uaae017","DOIUrl":"10.1093/bjrcr/uaae017","url":null,"abstract":"<p><p>Q fever is an epidemic disease caused by the <i>Coxiella burnetii</i> infection. It can manifest clinically as an acute or chronic disease, with chronic infections being more common. Q fever endocarditis is the most common manifestation of chronic infection and usually occurs in patients with previous valvular heart disease like in our present study, a case of Q fever endocarditis that occurred in background of tetralogy of Fallot surgical repair. However, Q fever endocarditis is difficult to diagnose clinically and may lead to very serious or even life-threatening outcomes if not diagnosed promptly. In the present study, accurate diagnosis and treatment were achieved by 18F-FDG PET/CT combined with detection of the Q fever serological antibodies.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11162745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Implications of lung shunt fraction calculation discrepancy in Yttrium-90 radioembolization treatment from 2D planar vs 3D single photon emission CT imaging. 二维平面与三维单光子发射 CT 成像对钇-90 放射性栓塞治疗中肺分流分数计算差异的影响。
IF 0.6
BJR Case Reports Pub Date : 2024-05-28 eCollection Date: 2024-05-01 DOI: 10.1093/bjrcr/uaae016
Paula Gamero Kubota, Christopher Molvar, Robert Wagner, Emad Allam, James Halama, Judy R James
{"title":"Implications of lung shunt fraction calculation discrepancy in Yttrium-90 radioembolization treatment from 2D planar vs 3D single photon emission CT imaging.","authors":"Paula Gamero Kubota, Christopher Molvar, Robert Wagner, Emad Allam, James Halama, Judy R James","doi":"10.1093/bjrcr/uaae016","DOIUrl":"10.1093/bjrcr/uaae016","url":null,"abstract":"<p><p>The safety and efficacy of Yttrium-90 (Y-90) radio-embolization therapy is partly dependent on the lung shunt fraction (LSF). There may be a notable disparity between LSF when calculated using 2D planar imaging vs 3D single photon emission CT (SPECT); this can affect the total allowable Y-90 dose delivered and therefore change the effectiveness of the procedure. The case presented demonstrates an 81% decrease in LSF when calculated by SPECT as compared to 2D planar imaging. This case highlights the importance of considering the imaging technique and the potential discrepancies that can arise between planar and SPECT imaging in LSF assessment.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11162746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
One case of myxoid glioneuronal tumour in the left frontal lobe. 一例左额叶肌样胶质细胞瘤。
IF 0.6
BJR Case Reports Pub Date : 2024-04-30 eCollection Date: 2024-05-01 DOI: 10.1093/bjrcr/uaae014
Jiayi Chu, Sheng Hu, Gangping Wang, Jibo Hu, Wenbo Xiao
{"title":"One case of myxoid glioneuronal tumour in the left frontal lobe.","authors":"Jiayi Chu, Sheng Hu, Gangping Wang, Jibo Hu, Wenbo Xiao","doi":"10.1093/bjrcr/uaae014","DOIUrl":"10.1093/bjrcr/uaae014","url":null,"abstract":"<p><p>Myxoid glioneuronal tumour (MGNT), previously described as dysembryoplastic neuroepithelial tumour of the septum pellucidum, was classified as a new tumour type in the fifth edition of the WHO Central Nervous System Tumor Classification of 2021. This classification was based on its anatomical location, imaging features, and genetic characteristics. MGNTs are clinically rare and prone to misdiagnosis. In this report, we present a case of MGNT in the left frontal lobe, which was confirmed through surgical pathology.</p>","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11090993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reflection on the past and looking into the future-a celebration of 10 years of BJR|Case Reports. 回顾过去，展望未来--庆祝《BJR|案例报告》10 周年。
IF 0.6
BJR Case Reports Pub Date : 2024-03-22 eCollection Date: 2024-03-01 DOI: 10.1093/bjrcr/uaae010
Giulia A Zamboni
{"title":"Reflection on the past and looking into the future-a celebration of 10 years of <i>BJR</i>|<i>Case Reports</i>.","authors":"Giulia A Zamboni","doi":"10.1093/bjrcr/uaae010","DOIUrl":"https://doi.org/10.1093/bjrcr/uaae010","url":null,"abstract":"","PeriodicalId":45216,"journal":{"name":"BJR Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10963073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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